1821087750 NPI number — DR. LESLIE COHEN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821087750 NPI number — DR. LESLIE COHEN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

COHEN

Provider First Name:

LESLIE

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1821087750

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

10/08/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

401 LIBERTY AVE

Provider Second Line Business Mailing Address:

STE 2000

Provider Business Mailing Address City Name:

PITTSBURGH

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

15222-1029

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

412-230-8200

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

211 PARK ST

Provider Second Line Business Practice Location Address:

STURDY MEMORIAL HOSPITAL

Provider Business Practice Location Address City Name:

ATTLEBORO

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

02703-3143

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

508-236-7770

Provider Business Practice Location Address Fax Number:

508-223-3026

Provider Enumeration Date:

10/13/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  MD08843 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 4301042192 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 01076888A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 60245 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 2085R0202X , with the licence number: MD444247 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 043140277 . This is a "PRIVATE HEALTH CARE SYSTE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 3040704 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0008817 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 000000028360 . This is a "HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: B270145002 . This is a "CIGNA MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 04-3140277 . This is a "HCVM FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 04-3140277 . This is a "GREAT WEST HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 043140277 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 300035287 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: J07692 . This is a "HMO BLUE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 60245 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: BCBS RI . This is a "4700" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: J07692 . This is a "BLUE CARE ELECT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 16-00012 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 200660 . This is a "BLUE CHIP RI HMO" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
• Identifier: 24406 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: J07692 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".